11D2248169 CLIA NUMBER - HEALING ROOTS FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 11D2248169
  • Facility Name: HEALING ROOTS FAMILY PRACTICE
  • Facility Address: 111 NORTH PINE STREET
    TRENTON, GA
    ZIP 30752
  • Facility Phone: 706 657-4325
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CRYSTAL HANCOCK
  • NPI Number: 1831858802
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2248169
LAB Type Physician Office
Facility Name HEALING ROOTS FAMILY PRACTICE
Street 111 NORTH PINE STREET
City TRENTON
State GA
ZIP 30752
Phone 706 657-4325
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/12/2024
Certificate Expiration Date 1/11/2026
Facility Type Physician Office
Lab Director CRYSTAL HANCOCK

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This page was last updated on: 9/29/2025